Evidence map›Paper›PMID 41071234›Full record

ArticlePituitary2025

Development and validation of clinical screening systems for Cushing disease in the United States.

Jorge E Salcedo-Sifuentes, Sonal Mehta, Carter M Suryadevara, Marvin Bergsneider, Kevin C J Yuen, Paul A Gardner, Julie M Silverstein, Albert H Kim, James J Evans, Garni Barkhoudarian and 17 more

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pituitary, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Jorge E Salcedo-SifuentesDepartment of Neurosurgery, University of California, Los Angeles, CA, United States.
Sonal MehtaDivision of Endocrinology, Department of Medicine, New York University, 222 E 41 st St, 23rd Floor, New York, NY, 10017, USA.
Carter M SuryadevaraDepartment of Neurosurgery, New York University, New York, NY, USA.
Marvin BergsneiderDepartment of Neurosurgery, University of California, Los Angeles, CA, United States.
Kevin C J YuenDepartment of Endocrinology Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States.
Paul A GardnerDepartment of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Julie M SilversteinDivision of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, MO, USA.
Albert H KimDepartment of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
James J EvansDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Garni BarkhoudarianDepartment of Neurosurgery, Pacific Neuroscience Institute Providence St. Johns Medical Center, Santa Monica, CA, USA.
Juan C Fernandez-MirandaDepartment of Neurosurgery, Stanford University, Palo Alto, CA, United States.
William T CouldwellDepartment of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
Robert C RennertDepartment of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
Varun R KshettryDepartment of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Kyle C WuDepartment of Neurological Surgery, The Ohio State College of Medicine, The Ohio State University, Columbus, OH, USA.
Carolina BenjaminDepartment of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA.
Gabriel ZadaDepartment of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Michael R ChicoineDepartment of Neurosurgery, University of Missouri, Columbia, MO, USA.
Jamie J Van GompelDepartment of Neurosurgery, Mayo Clinic, Rochester, MN, United States of America.
Michael P CatalinoDepartments of Neurosurgery and Medicine, Division of Endocrinology & Metabolism), University of Virginia, Charlottesville, VA, USA.
Michael KarsyDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
Adam MamelakDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Ildiko TorokDepartment of Neurological Surgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States.
Trevor LowDepartment of Neurological Surgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States.
Won KimDepartment of Neurosurgery, University of California, Los Angeles, CA, United States.
Donato R PacioneDepartment of Neurosurgery, New York University, New York, NY, USA.
Nidhi AgrawalDivision of Endocrinology, Department of Medicine, New York University, 222 E 41 st St, 23rd Floor, New York, NY, 10017, USA. Nidhi.Agrawal@nyulangone.org.

Funding

UCLA SPORE in Brain CancerP50CA211015 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Yvonne Yu-Hsuan Chen · 2017 to 2026
$25.2M
NCI NIH HHS P50 CA211015
6 · The paper itself

Abstract

purposeClinical screening systems (CSSs) for Cushing syndrome (CS) validated in Europe have not been evaluated for CS or Cushing disease (CD) in the United States (US). We aimed to evaluate existing CSSs in US patients and develop two new symptom-based CSSs to identify patients with high pre-test probability of disease warranting referral for definitive biochemical workup-one for broad CS screening and one specifically for CD.

methodsData were obtained from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID)-comprising 615 patients who underwent transnasal transsphenoidal resection for CD at one of 11 US pituitary centers, the Centers for Disease Control and Prevention's 2019 National Health Interview Survey (NHIS)-comprising 31,997 US respondents, and a single institution CD-NFA cohort-comprising 468 US patients diagnosed with either CD (n = 385) or nonfunctioning adenoma (n = 83). The RAPID Community Cushing CSS was derived from differences between the RAPID and NHIS cohorts, and the RAPID CD CSS from differences between patients with CD versus NFA.

resultsIn external validation using US-based cohorts, the RAPID Community CSS achieved an AUC of 0.707, compared to the Spanish (AUC = 0.691) and Italian (AUC = 0.685) models, and the RAPID CD CSS demonstrated greater external sensitivity (0.836, threshold = 0.5) at the Youden-optimized threshold than the Spanish (0.605, threshold = 4) and Italian (0.735, threshold = 6) CSSs.

conclusionsIn US patient populations, the RAPID Community Cushing CSS demonstrated superior discriminative ability for CD compared to the Italian and Spanish CSSs, and the RAPID CD CSS achieved the highest sensitivity for CD among all CSSs evaluated.

Indexed as

Mass ScreeningPituitary ACTH HypersecretionAdenomaAdultAgedCushing SyndromeFemaleHumansMaleMiddle AgedUnited StatesClinical screening systemCushing diseaseCushing syndromeLarge language modelPituitary registryScreening

Identifiers

PMID41071234
PMCPMC12513928

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.